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Patients with body integrity identity disorder (BIID) experience a strong desire for amputation from very early on. BIID patients are often dismissed when they share their wish for amputation with surgeons. Consequently, patients resort to self-amputation, including complications and sometimes death. BIID patients are not psychotic and are mentally competent to oversee the consequences of an elective amputation. The authors offer arguments in favor of elective amputation.

The name of Hippocrates is associated with a hoped-for standard of medical morality. The modern popularity of the Hippocratic Oath has come about at a time when most historians of ancient medicine, following Ludwig Edelstein's arguments, no longer believe that it was written by the historical Hippocrates or that many of its precepts were widely followed by the average Greek doctor of the fifth century BCE. Instead, it has become a symbol, legitimating modern ideals by an appeal to ancient, perhaps eternal, values. What these values are thought to be, and what is understood as Hippocratic, often differs. Even Nazi medical murderers believed that they were continuing to follow the way of Hippocrates, and became indignant when their interpretations of the Hippocratic Oath were rejected. In such circumstances, the history of the survival of Hippocratic morality becomes a history of medical ethics in itself.

The image of Hippocrates and the precepts of the Hippocratic Oath and related texts had an important influence on medical ethics in Europe and the Middle East from the ancient period onward. The relative insecurity of medicine within the social order partly accounts for the overt preoccupation with reputation, and likewise for the defensive and often polemical tone with which some Hippocratic writer's stake out the claims of their new, nonmagical medicine. Several versions of the Oath were attributed to Hippocrates in antiquity. The inclusion of numerous abortifacients in the doctor's pharmacological arsenal suggest that at least some Hippocratics also dispensed such drugs, as did numerous later Greek physicians. In other Hellenistic medical works, some of the emphases traced in the Hippocratic Corpus also emerge. Galen's valorization of truthfulness with one's patients is to some extent at odds with emphases in the postclassical Hippocratic deontological treatises.

A disaster is characterized by an imbalance between needs and supplies. In circumstances in which there occur mass casualties, it is not possible to provide care for all of the victims. Thus, it may be necessary to triage the casualties according to pre-established priorities. The performance of triage is associated with many ethical issues.

Currently, no Europe-wide agreement on triage and ethics exists. One system based on a categorization into four groups is proposed. Triage should be avoided whenever possible, but, when it is required, there is an obligation to respect human rights and the humanitarian laws, especially with reference to the Geneva Convention of 1864 and the Universal Declaration of Human Rights of 1948. The condition of informed consent must be followed, even in mass casualty situations. Triage always must follow established medical criteria and cannot be based on any other principles. Triage implies constant re-evaluation of victims as conditions of the victims and of available resources change continuously. In order to facilitate international coordination and cooperation, a universal classification system must be adopted.

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